Hospital staff and nursing staff

Question

Hello,
I have seen a statement in the internet (however in a not quite qualified forum) which did alarm me.
A nurse states there, that about 80% of the staff in German hospitals were carriers of the MRSA.

Even if the exact number is not as high:
It would interest me if the hospital staff is overall regularly tested for MRSA and which consequence a positive finding has. Is somebody, who carries the MRSA, allowed to work in a hospital? Can for example a correct hand hygiene prevent that an "MRSA-positive" doctor (nurse etc.) transmitts the germ to his patients?

MRSA is going to be registrable at june according to the internet: what does change for the patients due to this?
Many thanks for your answer.

Answer

Hello,
in an actual study 100 employees out of 5 surgical units are investigated, out of those showed 13 a Staphylococcus aureus and 2 out of these a Methicillin-resistant Stapyhlococcus aureus (MRSA). Similar data is reported from different countries, however there are differences between the countries and different sub-units in the health care system. In old-people's homes, for example, the frequency of MRSA is higher compared to other areas.
The named number of 80% is therefore in any case massively exaggerated.

In healthy persons, problematic germs, such as MRSA are in general removed from the airways via an intact self cleaning of the airways (clearance). It is searched for a permanent colonization of the employees if patients,who are cared for in a special unit, do show an MRSA cumulatively. For this, recommendations of the Robert-Koch institute (Germany) exist.

It is very important to stick to the given hygiene recommendations, in oder that the problematic germ is not transmitted from one patient to the other.
Hereby the hands of the staff or the infected person are the most important way of transmitting the MRSA, therefore the correct hand hygiene is the important cornerstone of stopping the transmission. However, as the MRSA is mainly found in the nose and sometimes also in the throat and sputum, it can be transmitted via droplet infection, so that other measures, such as face mask are necessary.
Concerning the consequences for an employee with a positive finding of MRSA, the Robert-Koch institute states that a MRSA carrier should not care for or treat a patient unless a successfull sanitation took place. So in most cases staff stays at home until the MRSA sanitation completed, sometimes they can go on working under strict conditions (e.g. without intensive patient contact, consequent hand disinfection, face mask).
These are the recommendations of the Rober-Koch institute, however they have no legal bonds, so that every hospital has a bit different way of regulating this topic.
Concerning the registration: this applies only to the finding of MRSA in the blood culture or in the fluid of the central nervous system. Therefore this does not mean a change for the patients at this timepoint.

Yours sincerely,
J. Mainz

11.08.2009